Postmenopausal bone health may be influenced by the presence of arterial hypertension and antihypertensive therapy

Abstract

Introduction:  Despite available evidence for a link between bone health and arterial hypertension (AH), the results of clinical trials remain conflicting. Thus, we conducted a cross-sectional study to analyze a possible association between blood pressure (BP), antihypertensive therapy and deteriorating bone health in postmenopausal women.  Materials and Methods:  The study included 84 women from Northeastern Bulgaria. Their mean age was 60.54 ± 7.07 years, and their mean duration of menopause was 11.45 ± 6.62 years. Bone health was assessed by dual-energy X-ray absorptiometry (DEXA) and by analysis of bone metabolic markers.  Results:  A significant negative correlation was established between bone mineral density (BMD) and diastolic BP. On the other hand, AH predominated in the studied population. However, among the subjects diagnosed with osteopenia and osteoporosis, a significantly higher proportion of AH was observed. In addition, differences were found according to the stage of AH and according to the intake of antihypertensive therapy, when assessing BMD and fracture risk. In subjects with newly diagnosed and respectively untreated AH as well as in the group of stage III AH, the lowest BMD and the highest fracture risk were found. Although we reported a significant difference in the mean age of women according to the presence of AH and its stages, after further analysis it was found that the presence of AH is an independent risk factor for bone health in postmenopausal women (OR = 2.14 (0.686–6.703); p = 0.015).  Conclusion:  According to the obtained results, we assumed that AH was risk factor for bone health in postmenopausal women, as it was associated with lower BMD and higher fracture risk. In addition, we found differences according to the stage of AH and antihypertensive therapy, which might be considered in the prevention, prophylaxis and treatment of osteoporosis.